Wisconsin Department of Safety and Professional Services Division of Policy Development

4822 Madison Yards Way

PO Box 8366 Madison WI 53705-8366

Phone: 608-266-2112 Web: http://dsps.wi.gov

Email: dsps@wisconsin.gov

Tony Evers, Governor

Dawn B. Crim, Secretary

MEDICAL EXAMINING BOARD

Room N208, 4822 Madison Yards Way, Madison

Contact: Yolanda Y. McGowan (608) 266-2112

April 17, 2019

The following agenda describes the issues that the Board plans to consider at the meeting. At the time of the

meeting, items may be removed from the agenda. Please consult the meeting minutes for a record of the actions

of the Board.

AGENDA

8:00 A.M.

OPEN SESSION – CALL TO ORDER – ROLL CALL

A. Adoption of Agenda (1-4)

B. Approval of Minutes of March 20, 2019 (5-8)

C. Conflicts of Interest

D. Administrative Matters

1. Board, Department, and Staff Updates

2. Board Members – Term Expiration Dates

a. Alaa Abd-Elsayed – 07/01/2020

b. David Bryce – 07/01/2021

c. Mary Jo Capodice – 07/01/2018

d. Michael Carton – 07/01/2020

e. Padmaja Doniparthi – 07/01/2021

f. Rodney Erickson – 07/01/2019

g. Bradley Kudick – 07/01/2020

h. Lee Ann Lau – 07/01/2020

i. David Roelke – 07/01/2021

j. Kenneth Simons – 07/01/2018

k. Timothy Westlake – 07/01/2020

l. Robert Zoeller – 07/01/2019

m. Vacant Public Member

3. Screening Panel and Examination Panel Appointments

4. Wis. Stat. § 15.085 (3)(b) – Affiliated Credentialing Boards’ Biannual Meeting with the Medical

Examining Board to Consider Matters of Joint Interest

E. Legislation and Rule Matters – Discussion and Consideration

1. Legislation and Pending or Possible Rulemaking Projects

F. Speaking Engagement(s), Travel, or Public Relation Request(s), and Reports (9)

1

1. Speaking Engagement Request from Advanced Pain Management for May 18, 2019 in

Waukesha, WI

G. Disaster Response – Discussion (10-22)

H. Elections, Appointments, Reappointments, Confirmations, and Committee, Panel and Liaison

Appointments (23-26)

I. Federation of State Medical Boards (FSMB) Matters

J. Controlled Substances Board Report – Timothy Westlake

K. Interstate Medical Licensure Compact Commission (IMLCC) – Report from Wisconsin’s

Commissioners

L. Newsletter Matters

M. Screening Panel Report

N. Informational Items

O. Discussion and Consideration of Items Added After Preparation of Agenda

1. Introductions, Announcements and Recognition

2. Administrative Updates

3. Elections, Appointments, Reappointments, Confirmations, and Committee, Panel and Liaison

Appointments

4. Council Appointment Matters

5. Education and Examination Matters

6. Credentialing Matters

7. Practice Matters

8. Future Agenda Items

9. Legislation/Administrative Rule Matters

10. Liaison Report(s)

11. Newsletter Matters

12. Annual Report Matters

13. Informational Item(s)

14. Division of Legal Services and Compliance (DLSC) Matters

15. Presentations of Petition(s) for Summary Suspension

16. Presentation of Proposed Stipulation(s), Final Decision(s) and Order(s)

17. Presentation of Proposed Decisions

18. Presentation of Interim Order(s)

19. Petitions for Re-Hearing

20. Petitions for Assessments

21. Petitions to Vacate Order(s)

22. Petitions for Designation of Hearing Examiner

23. Requests for Disciplinary Proceeding Presentations

24. Motions

25. Petitions

26. Appearances from Requests Received or Renewed

27. Speaking Engagement(s), Travel, or Public Relation Request(s), and Reports

P. Future Agenda Items

2

Q. Public Comments

CONVENE TO CLOSED SESSION to deliberate on cases following hearing (§ 19.85 (1) (a), Stats.); to

consider licensure or certification of individuals (§ 19.85 (1) (b), Stats.); to consider closing disciplinary

investigations with administrative warnings (§ 19.85 (1) (b), Stats. and § 448.02 (8), Stats.); to consider

individual histories or disciplinary data (§ 19.85 (1) (f), Stats.); and to confer with legal counsel (§ 19.85 (1)

(g), Stats.).

R. Consideration of Waiver of 24 Months of ACGME/AOA Approved Post-Graduate Training

1. Nishant Saran, M.D. (27-307)

S. Deliberation on Division of Legal Services and Compliance (DLSC) Matters

1. Recusal of Board from 18 MED 147 and 19 MED 026 (308)

2. Administrative Warnings

a. 17 MED 537 – R.E.S. (309-310)

b. 18 MED 094 – C.E.L. (311-312)

c. 18 MED 186 – W.G.D. (313-314)

d. 18 MED 210 – R.A.H. (315-316)

e. 18 MED 213 – E.C.R. (317-318)

f. 18 MED 235 – L.L.T. (319-320)

3. Stipulations, Final Decisions and Orders

a. 15 MED 374 – Thomas E. Goodrich, M.D. (321-326)

b. 16 MED 139 – John D. Whelan, M.D. (327-332)

c. 17 MED 146 – Roderick D. Koehler, M.D. (333-338)

d. 17 MED 266 – Thomas M. Naughton, M.D. (339-346)

e. 17 MED 372 – Sobia Kirmani-Moe, M.D. (347-353)

f. 18 MED 001 – Barbara J. Gonzales, M.D. (354-361)

g. 18 MED 224 – Brandon J. Rebholz, M.D. (362-367)

4. Case Closing(s)

a. 14 MED 251 – W.S.N. (368-379)

b. 15 MED 424 – M.T. (380-381)

c. 16 MED 478 – K.B. (382-384)

d. 17 MED 061 – D.S. & L.D. (385-395)

e. 17 MED 176 – M.P. (393-412)

f. 17 MED 185 – N.H. (413-419)

g. 17 MED 379 – L.S. (420-422)

h. 17 MED 418 – V.I. (423-427)

i. 18 MED 012 – C.L. (428-447)

j. 18 MED 197 – Unknown (448-450)

k. 18 MED 198 – Unknown (451-453)

l. 18 MED 241 – J.O. (454-456)

m. 18 MED 499 – A.B. (457-466)

n. 18 MED 625 – E.R. (467-469)

o. 18 MED 630 – B.S. (470-474)

p. 19 MED 008 – Unknown (475-477)

5. Monitoring (478-493)

3

a. Jong Kim, M.D. – Violation of Board Order

T. Open Cases

U. Consulting with Legal Counsel

V. Deliberation of Items Added After Preparation of the Agenda

1. Education and Examination Matters

2. Credentialing Matters

3. DLSC Matters

4. Monitoring Matters

5. Professional Assistance Procedure (PAP) Matters

6. Petition(s) for Summary Suspensions

7. Proposed Stipulations, Final Decisions and Orders

8. Administrative Warnings

9. Proposed Decisions

10. Matters Relating to Costs

11. Complaints

12. Case Closings

13. Case Status Report

14. Petition(s) for Extension of Time

15. Proposed Interim Orders

16. Petitions for Assessments and Evaluations

17. Petitions to Vacate Orders

18. Remedial Education Cases

19. Motions

20. Petitions for Re-Hearing

21. Appearances from Requests Received or Renewed

W. RECONVENE TO OPEN SESSION IMMEDIATELY FOLLOWING CLOSED SESSION

X. Vote on Items Considered or Deliberated Upon in Closed Session, if Voting is Appropriate

Y. Open Session Items Noticed Above Not Completed in the Initial Open Session

Z. Delegation of Ratification of Examination Results and Ratification of Licenses and Certificates

ADJOURNMENT

ORAL EXAMINATION OF CANDIDATES FOR LICENSURE

ROOM N207

10:00 A.M., OR IMMEDIATELY FOLLOWING THE FULL BOARD MEETING

CLOSED SESSION – Reviewing Applications and Conducting Oral Examination of Two (2) (at time of

agenda publication) Candidates for Licensure – Dr. Mary Jo Capodice and Dr. Kenneth Simons

NEXT MEETING DATE: MAY 15, 2019

******************************************************************************************

MEETINGS AND HEARINGS ARE OPEN TO THE PUBLIC, AND MAY BE CANCELLED WITHOUT

NOTICE.

4

Medical Examining Board Meeting Minutes March 20, 2019

Page 1 of 4

MEDICAL EXAMINING BOARD MEETING MINUTES

MARCH 20, 2019

PRESENT: Alaa Abd-Elsayed, M.D.; David Bryce, M.D.; Mary Jo Capodice, D.O.; Michael Carton (via teleconference); Rodney Erickson, M.D. (via teleconference); Lee Ann Lau, M.D.; Bradley Kudick; Kenneth Simons, M.D.; Robert Zoeller, M.D.

EXCUSED: David Roelke, M.D.; Timothy Westlake, M.D.; Padmaja Doniparthi, M.D.

STAFF: Yolanda McGowan, DPD Division Administrator; Dale Kleven, Rule Coordinator; Kate Stolarzyk, Bureau Assistant; and other Department staff

CALL TO ORDER

Kenneth Simons, Chair, called the meeting to order at 8:06 a.m. A quorum of nine (9) members was confirmed.

ADOPTION OF AGENDA

Amendment to the Agenda • After item H. “Uniform Emergency Volunteer Health Practitioners Act”

o ADD: Additional Materials for item I. “Elections, Appointments, Reappointments, Confirmations, and Committee, Panel and Liaison Appointments”

• After item I. “Elections, Appointments, Reappointments, Confirmations, and Committee, Panel and Liaison Appointments”

o ADD: item J. “Division of Legal Services and Compliance Annual Report January 1, 2017 – December 31, 2018”

MOTION: Mary Jo Capodice moved, seconded by David Bryce, to adopt the agenda as amended. Motion carried unanimously.

APPROVAL OF MINUTES OF FEBRUARY 20, 2019

MOTION: Robert Zoeller moved, seconded by Bradley Kudick, to approve the minutes of February 20, 2019 published. Motion carried unanimously.

SPEAKING ENGAGEMENT(S), TRAVEL, OR PUBLIC RELATION REQUEST(S), AND REPORTS

MOTION: Bradley Kudick moved, seconded by Lee Ann Lau, to designate Mary Jo Capodice to speak on the Board’s behalf at the WAOPS Conference on June 27th, 2019 in Wausau, WI. Motion carried unanimously.

ELECTIONS, APPOINTMENTS, REAPPOINTMENTS, CONFIRMATIONS, AND COMMITTEE, PANEL AND LIAISON APPOINTMENTS

MOTION: Bradley Kudick moved, seconded by Lee Ann Lau, to appoint Chris R. Becker to the Respiratory Care Practitioners Examining Council as a Respiratory Care Practitioner Member as of 7/1/2019 for a term to expire on July 1, 2022. Motion carried unanimously.

5

Medical Examining Board Meeting Minutes March 20, 2019

Page 2 of 4

PUBLIC COMMENTS

MOTION: Lee Ann Lau moved, seconded by Alaa Abd-Elsayed, to recognize and thank Tom Ryan for his many years of dedicated service to the Medical Examining Board. Motion carried unanimously.

CLOSED SESSION

MOTION: Robert Zoeller moved, seconded by Bradley Kudick, to convene to Closed Session to deliberate on cases following hearing (§ 19.85 (1) (a), Stats.); to consider licensure or certification of individuals (§ 19.85 (1) (b), Stats.); to consider closing disciplinary investigations with administrative warnings (§ 19.85 (1) (b), Stats. and § 448.02 (8), Stats.); to consider individual histories or disciplinary data (§ 19.85 (1) (f), Stats.); and to confer with legal counsel (§ 19.85 (1) (g), Stats.). Kenneth Simons, the Chair, read the language of the motion aloud for the record. The vote of each member was ascertained by voice vote. Roll Call Vote: Alaa Abd-Elsayed – yes; David Bryce-yes; Mary Jo Capodice-yes; Michael Carton-yes; Rodney Erickson-yes; Bradley Kudick – yes; Lee Ann Lau – yes; Kenneth Simons-yes; Robert Zoeller-yes. Motion carried unanimously.

The Board convened into Closed Session at 8:33 a.m.

RECONVENE TO OPEN SESSION

MOTION: Mary Jo Capodice moved, seconded by Alaa Abd-Elsayed, to reconvene to Open Session. Motion carried unanimously.

The Board reconvened to Open Session at 9:03 a.m.

VOTE ON ITEMS CONSIDERED OR DELIBERATED UPON IN CLOSED SESSION

MOTION: David Bryce moved, seconded by Lee Ann Lau, to affirm all motions made and votes taken in Closed Session. Motion carried unanimously.

(Be advised that any recusals or abstentions reflected in the closed session motions stand for the purposes of the affirmation vote.)

CREDENTIALING MATTERS

Full Board Review

Siamak Karimian, M.D.

MOTION: Alaa Abd-Elsayed moved, seconded by David Bryce, to approve the application of Siamak Karimian, M.D., once all requirements are met. Motion carried unanimously.

6

Medical Examining Board Meeting Minutes March 20, 2019

Page 3 of 4

DELIBERATION ON DIVISION OF LEGAL SERVICES AND COMPLIANCE (DLSC) MATTERS

Stipulations, Final Decisions and Orders

15 MED 093 – Arvind Ahuja, M.D.

MOTION: Robert Zoeller moved, seconded by Alaa Abd-Elsayed, to adopt the Findings of Fact, Conclusions of Law and Order in the matter of disciplinary proceedings against Arvind Ahuja, M.D., DLSC Case Number 15 MED 093. Motion carried unanimously.

17 MED 426 – Larry R. Myers, M.D.

MOTION: Lee Ann Lau moved, seconded by Robert Zoeller, to adopt the Findings of Fact, Conclusions of Law and Order in the matter of disciplinary proceedings against Larry R. Myers, M.D., DLSC Case Number 17 MED 426. Motion carried unanimously.

(Yolanda McGowan recused herself and left the room for deliberation and voting in the matter concerning Larry R. Myers, M.D., DLSC Case Number 17 MED 426.)

17 MED 542 & 18 MED 032 – Bennett S. Walstatter, M.D.

MOTION: Lee Ann Lau moved, seconded by David Bryce, to adopt the Findings of Fact, Conclusions of Law and Order in the matter of disciplinary proceedings against Bennett S. Walstatter, M.D., DLSC Case Number 17 MED 542 & 18 MED 032. Motion carried unanimously.

18 MED 026 – Robert C. Buss, M.D.

MOTION: Robert Zoeller moved, seconded by Bradley Kudick, to adopt the Findings of Fact, Conclusions of Law and Order in the matter of disciplinary proceedings against Robert C. Buss, M.D., DLSC Case Number 18 MED 026. Motion carried unanimously.

18 MED 061 – James J. Yurcek, M.D.

MOTION: Alaa Abd-Elsayed moved, seconded by Bradley Kudick, to adopt the Findings of Fact, Conclusions of Law and Order in the matter of disciplinary proceedings against James J. Yurcek, M.D., DLSC Case Number 18 MED 061. Motion carried unanimously.

(Yolanda McGowan recused herself and left the room for deliberation and voting in the matter concerning James J. Yurcek, M.D., DLSC Case Number 18 MED 061.)

7

Medical Examining Board Meeting Minutes March 20, 2019

Page 4 of 4

Case Closings

MOTION: Rodney Erickson moved, seconded by Mary Jo Capodice, to close the following cases according to the recommendations by the Division of Legal Services and Compliance: 1. 16 MED 422 – C.A. – No Violation 2. 17 MED 300 – E.W. – No Violation 3. 17 MED 490 – L.S. – No Violation 4. 18 MED 077 – J.G. – Prosecutorial Discretion (P7) 5. 18 MED 133 – D.R.S. – No Violation 6. 18 MED 218 – A.D. – Insufficient Evidence 7. 18 MED 223 – J.A.S. – No Violation 8. 18 MED 270 – K.S. & S.L. – No Violation 9. 18 MED 290 – F.C. – No Violation Motion carried unanimously.

17 MED 537 – R.E.S. – No Violation

MOTION: Lee Ann Lau moved, seconded by Bradley Kudick, to refer DLSC Case Number 17 MED 537, against R.E.S., back to DLSC. Motion carried unanimously.

(Yolanda McGowan recused herself and left the room for deliberation and voting in the matter concerning DLSC Case Number 17 MED 537.)

DELEGATION OF RATIFICATION OF EXAMINATION RESULTS AND RATIFICATION OF LICENSES AND CERTIFICATES

MOTION: Bradley Kudick moved, seconded by Robert Zoeller, to delegate ratification of examination results to DSPS staff and to ratify all licenses and certificates as issued. Motion carried unanimously.

ADJOURNMENT

MOTION: Lee Ann Lau moved, seconded by David Bryce, to adjourn the meeting. Motion carried unanimously.

The meeting adjourned at 9:04 a.m.

8

State of Wisconsin Department of Safety & Professional Services

Revised 10/12

AGENDA REQUEST FORM 1) Name and Title of Person Submitting the Request:

Kate Stolarzyk, on behalf of Tom Ryan

2) Date When Request Submitted:

3/11/2019

Items will be considered late if submitted after 4:30 p.m. and less than: ▪ 10 work days before the meeting for Medical Board

▪ 14 work days before the meeting for all others

3) Name of Board, Committee, Council, Sections: Medical Examining Board

4) Meeting Date: 3/20/19

5) Attachments:

Yes

No

6) How should the item be titled on the agenda page?

A. Speaking Engagement(s), Travel, or Public Relation

Request(s), and Reports

1. Speaking Engagement Request from Advanced Pain

Management for May 18, 2019 in Waukesha, WI

7) Place Item in:

Open Session

Closed Session

Both

8) Is an appearance before the Board being scheduled?

Yes (Fill out Board Appearance Request)

No

9) Name of Case Advisor(s), if required: N/A

10) Describe the issue and action that should be addressed:

11) Authorization

Kate Stolarzyk 3/11/2019

Signature of person making this request Date

Supervisor (if required) Date

Executive Director signature (indicates approval to add post agenda deadline item to agenda) Date

Directions for including supporting documents: 1. This form should be attached to any documents submitted to the agenda. 2. Post Agenda Deadline items must be authorized by a Supervisor and the Policy Development Executive Director. 3. If necessary, Provide original documents needing Board Chairperson signature to the Bureau Assistant prior to the start of a meeting.

9

State of Wisconsin Department of Safety & Professional Services

AGENDA REQUEST FORM

1) Name and Title of Person Submitting the Request: Rod Erickson

2) Date When Request Submitted: 2/2019 Items will be considered late if submitted after 4:30 p.m. and less than:

10 work days before the meeting for Medical Board 14 work days before the meeting for all others

3) Name of Board, Committee, Council, Sections: Medical Examining Board 4) Meeting Date: 4/17/2019

5) Attachments: x Yes

No

6) How should the item be titled on the agenda page? Disaster Response - Discussion

7) Place Item in: x Open Session

Closed Session Both

8) Is an appearance before the Board being scheduled? If yes, who is appearing? No

9) Name of Case Advisor(s), if required:

10) Describe the issue and action that should be addressed: Background Material:

1) Uniform Emergency Volunteer Health Practitioners Act (Attachment) 2) FSMB Resolution Proposal – Emergency Licensure Following a National Disaster (Attachment) 3) North Carolina Rule – Physician Practice and Limited License for Disasters and Emergencies (Attachment)

11) Authorization Signature of person making this request Date Supervisor (if required) Date Bureau Director signature (indicates approval to add post agenda deadline item to agenda) Date

10

Uniform Emergency Volunteer Health Practitioners Act

Situation In the event of a natural or manmade catastrophe with a large number of casualties and loss of infrastructure disruption, many states including Wisconsin have limited ability to respond.

• No mechanism to bring in practitioners not licensed in Wisconsin

• Available resources very limited o National Guard limited (federal oversight) o Medical Reserve Corps limited (state oversight) o Disaster Medical Assistance Team (DMAT) limited (federal oversight)

Background

In the aftermath of Hurricane Katrina, it became apparent existing organizations and infrastructures were inadequate to provide prompt, effective emergency medical care. Multiple barriers existed.

• Volunteers were willing to come to the aid of communities o Not clear what roles they could fulfill o No licensing mechanism o No license, no liability protection

• Lack of infrastructure o Volunteer practitioners may have no place to provide services

• No easy expedient way to license o No oversight or jurisdiction o No limits: time, place, practice

Assessment

To address these deficiencies something was needed to provide states with the ability to access health manpower, especially licensed practitioners from outside jurisdictions rapidly, safely, and efficiently. One response has been the Uniform Emergency Volunteer Health Practitioners Act. In 2006, the National Conference of Commissioners on Uniform State Laws adopted a model bill to address the issue of health care practitioners providing care during a declared emergency in states where they may not be licensed to practice. The UEVHPA was developed in response to the significant

legal and licensing barriers to volunteer physicians and health care practitioners who would like to provide care in times of a declared emergency.

• Defines who may practice: professionals have registered with a public or private registration

system

• Provides licensure: permits those professionals to enter the state and provide services without

having to seek a license in the state

• Provides access to services: increasing access to care during a critically difficult situation where

licensure boards may be swamped with requests

• Helps define liability

• May be integrated into larger emergency response system including medical reserve corps

The Purpose of the UEVHPA

The UEVHPA establishes legal guidelines to allow volunteers to provide assistance during a time of declared emergency by recognizing other states’ licenses for physicians and health care

11

practitioners. Whereas federal provisions for interstate cooperation do not extend to most private practitioners, the UEVHPA calls for the creation of a registration system that out-of-state practitioners may use either before or during a disaster. Upon successful registration, practitioners are expressly permitted to contribute their professional skills to existing organized disaster efforts. In addition, the Act addresses issues of workers’ compensation coverage and civil liability protections for physicians and other licensed health care practitioners.

Why the UEVHPA Is Important to Physicians

Physicians are uniquely qualified to assist during disasters. Physicians with training in trauma and critical care, play a major role in the health care community’s response to most disaster situations. Properly trained volunteers are critical in such circumstances.

By enacting the UEVHPA, state legislatures can have a positive impact on disaster response effectiveness. Removing barriers that prohibit licensed surgeons and other qualified responders from traveling across state lines to voluntarily administer medically necessary care during disasters will ensure the citizens of their state have access to high-quality surgical services in the event of a crisis.

Recommendation

Propose legislation for an Emergency Volunteer Health Practitioners Act

Establishes the Uniform Emergency Volunteer Health Practitioners Act which

Applies to volunteer health practitioners (out of state/in-state) registered with the volunteer health practitioner registration system defined in the bill and who provide health or veterinary services in this state for a host entity while an emergency declaration is in effect.

Purpose

Authorizes the Department of Health or Department of Safety and Professional Services to regulate the use of in-state/out-of-state licensed volunteer health & veterinary practitioners during a Governor’s declared emergency.

• Authorizes registered volunteer health & veterinary practitioners licensed in other states to practice in the state during a declared emergency.

• Establishes standards for volunteer health practitioner registration.

Key points

• Requires: Volunteer Health Professionals to register with DHS/DSPS before or during an emergency

• Deployment Trigger: Requires Governor (state, regional or national) to issue State of Emergency Proclamation.

• Out-of-State: Volunteer Health Professionals licensed in good standing and registered by DHS/DSPS may practice in WI during a declared emergency.

DHS/DSPS may: • Limit, restrict, or otherwise regulate • Duration of Practice • Geographical areas • Types of Practitioners

Licensing Boards may:

• Sanction out-of-state practitioners for conduct occurring in WI during the emergency

12

• A Volunteer Health Practitioner that is injured or dies during deployment is deemed an employee of the state – L&I coverage *

• Liability protection for acts or omission while providing services * Benefits **

• Provides a pathway for in-state/out-of-state providers.

• Provides authorities for DHS/DSPS to manage & deploy state-level volunteer programs.

• Complements MRCs – Local volunteer program

• Allows local MRC members to register with DHS/DSPS for in-state deployment.

• Provides worker compensation liability protection.

• Provides authorities to deploy in-state DHS/DSPS registered volunteers as state employees for purposes of supporting an EMAC/PNEMA request.

uniform emergency volunteer healthcare practitioners act uniform ... www.ifrc.org/docs/idrl/367EN.pdf

States that have enacted UEVHPA model legislation include:

• Arkansas (2009) • Colorado (2007) • District of Columbia (2010) • Georgia (2016) • Illinois (2010) • Indiana (2008) • Kentucky (2007) • Louisiana (2009) • Maine (2018) • Nevada (2011) • New Mexico (2008) • North Dakota (2009) • Oklahoma (2009) • Oregon (2009) • Tennessee (2007) • Texas (2013) • Utah (2008) • Washington (2018) • West Virginia (2017)

13

Uniform Emergency Volunteer Health Practitioners Act

Situation In the event of a natural or manmade catastrophe with a large number of casualties and loss of infrastructure disruption, many states including Wisconsin have limited ability to respond.

• No mechanism to bring in practitioners not licensed in Wisconsin

• Available resources very limited o National Guard limited (federal oversight) o Medical Reserve Corps limited (state oversight) o Disaster Medical Assistance Team (DMAT) limited (federal oversight)

Background

In the aftermath of Hurricane Katrina, it became apparent existing organizations and infrastructures were inadequate to provide prompt, effective emergency medical care. Multiple barriers existed.

• Volunteers were willing to come to the aid of communities o Not clear what roles they could fulfill o No licensing mechanism o No license, no liability protection

• Lack of infrastructure o Volunteer practitioners may have no place to provide services

• No easy expedient way to license o No oversight or jurisdiction o No limits: time, place, practice

Assessment

To address these deficiencies something was needed to provide states with the ability to access health manpower, especially licensed practitioners from outside jurisdictions rapidly, safely, and efficiently. One response has been the Uniform Emergency Volunteer Health Practitioners Act. In 2006, the National Conference of Commissioners on Uniform State Laws adopted a model bill to address the issue of health care practitioners providing care during a declared emergency in states where they may not be licensed to practice. The UEVHPA was developed in response to the significant

legal and licensing barriers to volunteer physicians and health care practitioners who would like to provide care in times of a declared emergency.

• Defines who may practice: professionals have registered with a public or private registration

system

• Provides licensure: permits those professionals to enter the state and provide services without

having to seek a license in the state

• Provides access to services: increasing access to care during a critically difficult situation where

licensure boards may be swamped with requests

• Helps define liability

• May be integrated into larger emergency response system including medical reserve corps

The Purpose of the UEVHPA

The UEVHPA establishes legal guidelines to allow volunteers to provide assistance during a time of declared emergency by recognizing other states’ licenses for physicians and health care

14

practitioners. Whereas federal provisions for interstate cooperation do not extend to most private practitioners, the UEVHPA calls for the creation of a registration system that out-of-state practitioners may use either before or during a disaster. Upon successful registration, practitioners are expressly permitted to contribute their professional skills to existing organized disaster efforts. In addition, the Act addresses issues of workers’ compensation coverage and civil liability protections for physicians and other licensed health care practitioners.

Why the UEVHPA Is Important to Physicians

Physicians are uniquely qualified to assist during disasters. Physicians with training in trauma and critical care, play a major role in the health care community’s response to most disaster situations. Properly trained volunteers are critical in such circumstances.

By enacting the UEVHPA, state legislatures can have a positive impact on disaster response effectiveness. Removing barriers that prohibit licensed surgeons and other qualified responders from traveling across state lines to voluntarily administer medically necessary care during disasters will ensure the citizens of their state have access to high-quality surgical services in the event of a crisis.

Recommendation

Propose legislation for an Emergency Volunteer Health Practitioners Act

Establishes the Uniform Emergency Volunteer Health Practitioners Act which

➢ Applies to volunteer health practitioners (out of state/in-state) registered with the volunteer health practitioner registration system defined in the bill and who provide health or veterinary services in this state for a host entity while an emergency declaration is in effect.

Purpose

Authorizes the Department of Health or Department of Safety and Professional Services to regulate the use of in-state/out-of-state licensed volunteer health & veterinary practitioners during a Governor’s declared emergency.

• Authorizes registered volunteer health & veterinary practitioners licensed in other states to practice in the state during a declared emergency.

• Establishes standards for volunteer health practitioner registration.

Key points

• Requires: Volunteer Health Professionals to register with DHS/DSPS before or during an emergency

• Deployment Trigger: Requires Governor (state, regional or national) to issue State of Emergency Proclamation.

• Out-of-State: Volunteer Health Professionals licensed in good standing and registered by DHS/DSPS may practice in WI during a declared emergency.

DHS/DSPS may: • Limit, restrict, or otherwise regulate • Duration of Practice • Geographical areas • Types of Practitioners

Licensing Boards may:

• Sanction out-of-state practitioners for conduct occurring in WI during the emergency

15

• A Volunteer Health Practitioner that is injured or dies during deployment is deemed an employee of the state – L&I coverage *

• Liability protection for acts or omission while providing services * Benefits **

• Provides a pathway for in-state/out-of-state providers.

• Provides authorities for DHS/DSPS to manage & deploy state-level volunteer programs.

• Complements MRCs – Local volunteer program

• Allows local MRC members to register with DHS/DSPS for in-state deployment.

• Provides worker compensation liability protection.

• Provides authorities to deploy in-state DHS/DSPS registered volunteers as state employees for purposes of supporting an EMAC/PNEMA request.

uniform emergency volunteer healthcare practitioners act uniform ... www.ifrc.org/docs/idrl/367EN.pdf

States that have enacted UEVHPA model legislation include:

• Arkansas (2009) • Colorado (2007) • District of Columbia (2010) • Georgia (2016) • Illinois (2010) • Indiana (2008) • Kentucky (2007) • Louisiana (2009) • Maine (2018) • Nevada (2011) • New Mexico (2008) • North Dakota (2009) • Oklahoma (2009) • Oregon (2009) • Tennessee (2007) • Texas (2013) • Utah (2008) • Washington (2018) • West Virginia (2017)

16

Resolution 19-__

Federation of State Medical Boards House of Delegates Meeting

April 27, 2019 Subject: Emergency Licensure Following a Natural Disaster Introduced by: North Carolina Medical Board Approved: January 2019 ____________________________________________________________________________ Whereas, hurricanes and other natural disasters can cause mass injuries that are beyond a

state’s ability to manage with currently licensed physicians, and Whereas, in those situations, state medical and osteopathic boards (“boards”) must be able

to quickly process emergency license applications in a way that does not compromise public safety, and

Whereas, FSMB Policy 240.4 “License Portability During a Public Health Emergency” (April

2006) states “. . .. the FSMB [will] study issues relative to license portability during an emergency including, but not limited to, joining with other organizations or entities to determine the best manner to provide necessary medical care and maintain licensure autonomy for the individual states”, and

Whereas, FSMB Policy 240.6 “Disaster Preparedness and Licensing” (April 2002) states

“The FSMB will cooperate with federal and state legislators, agencies, and organizations in facilitating the movement of properly licensed physicians among FSMB member licensing jurisdictions in support of necessary emergency medical response”, and

Whereas, although good policies, they did not result in model emergency licensure laws

and rules, and Whereas, many boards, particularly those in hurricane-prone states, would benefit from

model emergency licensure laws and rules. Therefore, be it hereby

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Resolved, that the Federation of State Medical Boards convene a workgroup to develop model emergency licensure laws and rules and submit its recommendations to the House of Delegates at the 2020 FSMB Annual Meeting.

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21 NCAC 32B .1706 is proposed for adoption under temporary procedures as follows: 1 2 21 NCAC 32B .1706 PHYSICIAN PRACTICE AND LIMITED LICENSE FOR DISASTERS AND 3 EMERGENCIES 4 5 (a) The Board shall, pursuant to G.S. 90-12.5, waive requirements for licensure except to the extent set 6 forth below and after the Governor of the State of North Carolina has declared a disaster or state of 7 emergency, or in the event of an occurrence for which a county or municipality has declared a state of 8 emergency, or to protect the public health, safety or welfare of its citizens under Article 22 of Chapter 9 130A of the General Statutes. There are two ways for physicians to practice under this rule: 10

(1) Hospital to Hospital Credentialing: A physician who holds a full, unlimited and 11 unrestricted license to practice medicine in another U.S. state, territory or district and has 12 unrestricted hospital credentials and privileges in any U.S. state, territory or district may 13 come to North Carolina and practice medicine at a hospital that is licensed by the North 14 Carolina Department of Health and Human Services upon the following terms and 15 conditions: 16 (A) the licensed North Carolina hospital shall verify all physician credentials and 17

privileges; 18 (B) the licensed North Carolina hospital shall keep a list of all physicians coming to 19

practice and shall provide this list to the Board within ten (10) days of each 20 physician practicing at the licensed North Carolina hospital. The licensed North 21 Carolina hospital shall also provide the Board a list of when each physician has 22 stopped practicing medicine in North Carolina under this section within ten (10) 23 days after each physician has stopped practicing medicine under this section; 24

(C) all physicians practicing under this section shall be authorized to practice 25 medicine in North Carolina and shall be deemed to be licensed to practice 26 medicine in the State of North Carolina and the Board shall have jurisdiction over 27 all physicians practicing under this section for all purposes set forth in or related 28 to Article 1 of Chapter 90 of the North Carolina General Statutes, and such 29 jurisdiction shall continue in effect even after any and all physicians have stopped 30 practicing medicine under this section; 31

(D) a physician may practice under this section for the shorter of (a) thirty (30) days 32 from the date the physician has started practicing under this section or (b) a 33 statement by an appropriate authority is made that the emergency or disaster 34 declaration has been withdrawn or ended and, at such time, the license deemed 35 to be issued shall become inactive, and 36

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(E) physicians practicing under this section shall not receive any compensation 1 outside of their usual compensation for the provision of medical services during a 2 disaster or emergency. 3

(2) Limited Emergency License: A physician who holds a full, unlimited and unrestricted 4 license to practice medicine in another U.S. state, territory or district may apply for a 5 limited emergency license on the following conditions: 6 (A) the applicant must complete a limited emergency license application; 7 (B) the Board shall verify that the physician holds a full, unlimited and unrestricted 8

license to practice medicine in another U.S. state, territory or district; 9 (C) in response to the specific circumstances presented by a declared disaster or 10

state of emergency and in order to best serve the public interest, the Board may 11 limit the physician's scope of practice; 12

(D) the Board shall have jurisdiction over all physicians practicing under this section 13 for all purposes set forth in or related to Article 1 of Chapter 90 of the North 14 Carolina General Statutes, and such jurisdiction shall continue in effect even 15 after such physician has stopped practicing medicine under this section or the 16 Limited Emergency License has expired; 17

(E) this license shall be in effect for the shorter of (a) thirty (30) days from the date it 18 is issued or (b) a statement by an appropriate authority is made that the 19 emergency or disaster declaration has been withdrawn or ended and, at such 20 time, the license issued shall become inactive; and 21

(F) physicians holding limited emergency licenses shall not receive any 22 compensation outside of their usual compensation for the provision of medical 23 services during a disaster or emergency. 24

25 History Note: Authority G.S. 90-12.5; G.S. 90-13.2(e);G.S 90-14(a); GS 166A-45 26 27

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From: McGowan, Yolanda - DSPSTo: Stolarzyk, Kate - DSPSSubject: FW: UEVHPADate: Wednesday, April 10, 2019 4:18:15 PM

  

From: Erickson, Rodney A., M.D. <Erickson.Rodney@mayo.edu> Sent: Wednesday, April 10, 2019 4:02 PMTo: McGowan, Yolanda - DSPS <Yolanda.McGowan@wisconsin.gov>Subject: RE: UEVHPA ThanksIt was tabled last month to discuss this month as I was unable to attend in person in March.For the summary and FAQ, could we include the attachments, each is 2 pages. Jaclyn or someonecould do that.R 

From: McGowan, Yolanda - DSPS [mailto:Yolanda.McGowan@wisconsin.gov] Sent: Wednesday, April 10, 2019 1:38 PMTo: Erickson, Rodney A., M.D.Subject: [EXTERNAL] RE: UEVHPA Hi Dr. Erickson. For now, yes. I can have Kim add it to the agenda for discussion under legislativeupdates. Yolanda 

From: Erickson, Rodney A., M.D. <Erickson.Rodney@mayo.edu> Sent: Monday, April 08, 2019 6:39 PMTo: McGowan, Yolanda - DSPS <Yolanda.McGowan@wisconsin.gov>Subject: UEVHPA Yolanda,You are now our POC for MEB issues, correct? As you may or may not be aware I’m introducing the Universal Emergency Volunteer HealthPractitioners Act for discussion and I hope to eventually move forward for legislative support. There are volumes available, but I’d like to include at a minimum the summary, and the FAQ ishelpful.Not sure MEB members want the model bill as of yet.  FAQ 2 pageshttps://www.facs.org/~/media/files/advocacy/state/uevhpa%20fact%20sheet.ashx

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Summary 2 pageshttps://www.facs.org/~/media/files/advocacy/state/uevhpa%20summary.ashx Model bill, 16 pageshttps://www.facs.org/~/media/files/advocacy/state/uevhpa%20model%20bill.ashx ThanksRod The 2 minute elevator speech:The UEVHPA was developed in 2006 after existing programs were found to be extremely inadequateduring the response to hurricanes Katrina and Rita in 2005. Wide adoption of the UEVHPA along withcentral organization could provide a more effective response to national or regional crisis, especiallywhen local infrastructure is incapacitated. 

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State of Wisconsin Department of Safety & Professional Services

Revised 2/2015

AGENDA REQUEST FORM

1) Name and Title of Person Submitting the Request: Kimberly Wood, Program Assistant Supervisor-Advanced

2) Date When Request Submitted: 3/14/2019

Items will be considered late if submitted after 12:00 p.m. on the deadline date which is 8 business days before the meeting

3) Name of Board, Committee, Council, Sections: Medical Examining Board

4) Meeting Date: 4/17/19

5) Attachments: Yes No

6) How should the item be titled on the agenda page? Medical Examining Board – Council Member Appointment Matters

1) Respiratory Care Practitioners Examining Council a. Reappointments

i. Lynn Waldera

7) Place Item in: Open Session Closed Session

8) Is an appearance before the Board being scheduled? Yes (Fill out Board Appearance Request) No

9) Name of Case Advisor(s), if required: N/A

10) Describe the issue and action that should be addressed: The Board should determine how best to proceed with reappointments to the Respiratory Care Practitioners Examining Council.

Consider Reappointment to the Respiratory Care Practitioners Examining Council ii. Lynn Waldera – Applicant (Replace William Rosandick) Resume, Cover Letters and Application Attached

If the Board choose to reappoint Lynn Waldera, consider the following motion.

• Motion Language: to reappoint Lynn Waldera to the Respiratory Care Practitioners Examining Council as a Respiratory Care Practitioner Member for a term to expire on July 1, 2020.

11) Authorization Kimberly Wood

Signature of person making this request Date Supervisor (if required) Date Executive Director signature (indicates approval to add post agenda deadline item to agenda) Date Directions for including supporting documents: 1. This form should be attached to any documents submitted to the agenda. 2. Post Agenda Deadline items must be authorized by a Supervisor and the Policy Development Executive Director. 3. If necessary, provide original documents needing Board Chairperson signature to the Bureau Assistant prior to the start of a meeting.

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